I have had an under active thyroid gland for five to six years. I have two healthy girls, but I suffered a miscarriage at Christmas at ten weeks into ...

Question

I have two healthy girls, but I suffered a miscarriage at ten weeks into a pregnancy.

Now after a recent thyroid blood test, I have been asked to have a test for antithyroid antibodies.

I have read about the possible link with this and miscarriage.

Can you tell me if there is there a link, what they are testing for, and what they will do about it?

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Answer

I'm sorry to hear about your miscarriage. It's a difficult time that is often made worse by a lack of reasonable explanation.

I am reassured that you've had two successful pregnancies before your miscarriage, and to be honest I'd be surprised if you have an underlying problem.

It is true that there are some conditions that predispose to recurrent miscarriages in the early stages of pregnancy.

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Most doctors would not start looking for them until a couple had experienced two or three consecutive first trimester miscarriages.

These predisposing conditions are quite rare and miscarriages are relatively common.

It has been estimated that up to 20 per cent of women who've missed a period and know that they're pregnant suffer a miscarriage.

It's also possible that up to 50 per cent of conceptions don't make it, although most of them before the first period is missed.

An underactive thyroid can make miscarriage more likely if it has not been diagnosed and controlled around the time of conception and early pregnancy.

Effective replacement solves this problem and so it should no longer be relevant to you.

It's also well established that antibodies to cardiolipin and phospholipid have been associated with recurrent miscarriage in some women, and aspirin has been shown to improve the chance of a successful pregnancy for them.

I have managed to find a reference to thyroid autoantibodies (TG-Ab, TPO-Ab) which reports a significant association with the number of previous miscarriages suffered, but I'm not at all clear how this helps you in practice.

The specialist who asked you to have the test will have a better idea of how the result is going to change things for you, so I think you should seek further explanation there.

I'm sorry that I can't give you more background on your specific question.

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